I prefer to put 3 true levels (2 sections off of 3 different ribbons, 50-60 um between levels, given adequate tissue size), picking up the sections horizontally on the slide. In this way you get 6 diagnostic sections on one slide. Saves space on the stainer. I find you really have to stress adequate hydration/cooling of the blocks to avoid artifact, especially in a lab where the bxs are not run on a separate processor/ protocol. This doesn't mean you can leave blocks floating in your icetray while you go to lunch. But a good 5-10 mins on ice really helps. Also, I find I physically slow down my microtome stroke a little when cutting GI bxs, and cut nice long ribbons. The sections in the middle of a long ribbon will exhibit very little variability in thickness. When you see a slide with 3 sections on it, each of a different thickness, it's usually the result of an inexperienced or rushed tech cutting 3-4 section "ribbons" without allowing for adequate cooling/hydration time. I have also frequently QC'd slides in which the first slide is good, but the next 2 levels progressively deteriorate. This is due to inadequate hydration/cooling between levels. Again, it behooves everyone to really slow down and take your time cutting GI bxs.
On Fri, Mar 14, 2014 at 1:35 PM, Barbara Tibbs < barbara.ti...@accuratediagnosticlabs.com> wrote: > Dr. Richmond, > > A large portion of our business is GI biopsies. We cut three levels per > slide. We achieve this by cutting three ribbons at different levels and > picking up two sections from each ribbon. If an H.pylori or AB/PAS is > ordered we choose two sections from the middle ribbon. I check the quality > of the slides before handing them out to the pathologists. I encourage the > pathologists to share any unhappiness they have with our microtoming and > work to improve the problem ASAP. > > It seems to me that skilled, caring histotechnologists plus good > communication with the pathologists is the magic equation for excellent > quality slides. > > Barbara S. Tibbs > Histology Supervisor > Accurate Diagnostic Labs > South Plainfield, NJ > barbara.ti...@accuratediagnosticlabs.com > 732-839-3374 > Cell: 610-809-6508 > > > ________________________________________ > From: histonet-boun...@lists.utsouthwestern.edu < > histonet-boun...@lists.utsouthwestern.edu> on behalf of Bob Richmond < > rsrichm...@gmail.com> > Sent: Friday, March 14, 2014 10:37 AM > To: Histonet@lists.utsouthwestern.edu > Subject: [Histonet] Re: GI biopsies > > An anonymous query: >>I was just curious about how your institutions handle > GI biopsies, specifically how many slides you cut off the bat. We presently > cut 2 levels on each GI biopsy block, but I'm hearing that more and more > places only cut 1 slide per GI biopsy block. Please share what you are > doing at your establishment.<< > > Well, I take what I can get. Many histotechs lack the skill, or are > unwilling to lay more than one ribbon on a slide. I do like more than one > level. > > A more serious problem is maintaining the quality of GI biopsy sections, > one of the most difficult quality assurance issues in histopathology. (It > was reviewed in J HIstotechnol last year - I can find the reference.) The > problem is at its worst with duodenal biopsies, where some services never > prepare an adequate slide. As the "celiac disease" fad spreads and bread is > the Evil Food of the Year, I am really concerned about signing out duodenal > biopsies where I can't even distinguish the lymphocytes. > > Edwards Deming lives! > > Bob Richmond > Samurai Pathologist > Maryville TN > _______________________________________________ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > > _______________________________________________ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet